DIFFERENT FIELDS OF NURSING

CLASSIFICATION OF FIELDS OF NURSING IN GENERAL The fields of nursing may be classified according to the following: 1. Hospital or Institutional Nursing 2. Public Health Nursing or Community Health Nursing 3. Private Duty or Special Duty Nursing 4. Industrial or Occupational Health Nursing 5. Nursing Education 6. Military Nursing 7. School Nursing 8. Clinic nursing 9. Independent Nursing Practice

INSTITUTIONAL NURSING Nursing in hospital and related health facilities such as extended care facilities, nursing homes, and neighborhood clinics, comprises all of the basis components of comprehensive patient care and family health. The concept of the modern hospital as a community health center where in-patient and out-patient care are continuous describes the goal of medical care in most general hospitals. The educational qualification for beginning practitioners is a Bachelor of Science in Nursing degree. The nurse as a member of the health care team, participate in all phases of patient care of the acutely ill, the convalescing and the ambulatory patient. The nurse cares for the patient in the hospital or in the out-patient department and plants for the nursing care needs of the patient about to be discharged. The nurse performs nursing measure that will meet the patients physical, emotional, social, and spiritual health needs while in the institution and helps him and his family plan for his further health care needs when he returns home. The nurses function involve assessment of the patients needs for

nursing and planning for giving or providing the care indicated whether this be personal care, rehabilitation measures or health instructions. These function include participation in the research and training carried on in the hospital, teaching auxiliary personnel and assisting in teaching and supervision of nursing and/or midwifery students, if there are affiliates in the said institution.

Advantages of Staff Nursing in Hospitals 1. There is always a supervisor whom one can consult if problems exist. 2. Nurses updated with new trends in medicine and in nursing care of patients. 3. They undergo rotation of different units and have a chance to determine their special area of choice before they are assigned permanently in one area such as Medicine, pediatrics, surgery, ICU-CCU, Obstetrics, Operating Room, Delivery Room, etc. 4. They have an eight-hours day and a forty-hour week duty which provide for two days of rest away from duty. They have provisions for sick leaves, holidays, and vacations with ay according to personnel policies of the institution. 5. They have the chance to get promoted to higher positions if they are qualified. 6. Salary increases are given periodically according to merit system thereby increased their initiative and best efforts. 7. They are considered an important member of the health team in providing care to the patients. 8. More staff development programs are available in hospitals. Disadvantage of Staff Nursing in Hospitals The disadvantages usually do not outweigh the advantages: 1. There is a great possibility of understaffing which may require nurses to put in overtime work and sacrifice some of their plans. This is especially true in hospitals where budget for personnel is limited.

2. Because of the bulk of works, some staff nurses do not find time to improve their skills through continuing education programs. Or, if the hospitals are far-flung, no continuing education programs are provided. 3. Administrative problems and overwork may tend to dissatisfy the staff nurse.

Qualification of Nursing Service Administrators Section 29 of RA 9173 specifies that a person occupying supervisory or managerial positions requiring knowledge of nursing must: a) Be a registered nurse in the Philippines; b) Have at least two (2) years of experience in general nursing service administration; c) Possess a degree of Bachelor of Science in Nursing, with at least nine (9) units in management and administration courses at the graduate level; and d) Be a member of good standing of the accredited professional organization of nurses.

It is provided, however, that a person occupying the position of chief nurse or director of nursing services, shall, in addition to the foregoing qualifications, possess: a) At least five (5) years of experience in a supervisory or managerial position in nursing; and b) A masters degree major in Nursing.

It is further provided that for primary hospital, the minimum academic qualifications and experiences for a chief nurse shall be as specified in subsections (a), (b), and (c) of this section: Provided, furthermore, That for the chief nurses in the public health agencies. Those who have a masters degree in public health/ community health nursing shall be given priority. Provided, even further, That for chief nurses in military hospitals, priority shall given to those who have finished a masters degree in nursing and

completion of the General Staff Course (GSC): Provided finally, That those occupying such positions before the effectively of this Act shall given a period of (5) years within which to qualify. A new trend in hospital nursing is clinical specialization. Nurses train n a special field of nursing of their choice. Courses to prepare nurses desiring to perfect their clinical opportunities are offered in universities, usually at the masters level. These nurses must have the experience required before applying for a position as an expert practitioner. Memorandum Circular No. 2000-05, series of 2000 of the Professional Regulation Commission, Board of Nursing, mandates the implementation of this provision of the Philippines Nursing Act.

Nursing Specialty Certification In this country, a Nursing Specialty Certification Program has been adopted by the Board of Nursing through Resolution No. 14 series of 1999, and created a Nursing Certification Council under it to oversee the administration of new programs by the Specialty Certification Boards (refer to Appendices L and M). SEC. 29. Comprehensive Nursing Specialty Program. within ninety (90) days from the effectively of this Act, the Board in coordination with the accredited professional organization, recognize specialty organization and the Department of Health is hereby mandated to formulate and develop a comprehensive nursing specialty program that would upgrade the level of skills and competence of specialty nurse clinicians in the country, such as not limited to the areas of critical care, oncology, renal and such other areas as may be determined by the Boards. The beneficiaries of this program are obliged to serve in any Philippine hospital for a period of at least two (2) years of continuous service. Sec. 33. Funding for the Comprehensive Nursing Specialty Program. the annual financial requirement needed to trait at least ten percent (10%) of the nursing staff of the participating government hospital shall be chargeable against the income of the

Philippine Charity Sweepstakes Office and the Philippine Amusement and Gaming Corporation, which shall equally share in the costs and shall be released to the

Department of Health subject to accounting and auditing procedures: Provided, That the Department of Health shall set the criteria for the availment of this program.

Benefits of Certification Certification offers advantage to the individual nurse, the nursing profession, and the health delivery system. 1. Nurses certified above minimum standards improve the quality of patient care. 2. Certification measures expertise beyond that which measured in basic licensure. 3. Certification ensures continued in competence in the changing world of health care. 4. Certification is a means of confronting of the demands of health care. 5. It is a life long learning that advances nursing skills and knowledge to move the profession forward. 6. It enhances the nurses self image and the public views of the profession.

What is the future of the hospital nursing? All indication point to the development of additional in nursing specialization that will attract large numbers of nurses with varied educational backgrounds and who have had many kind of clinical experiences such as critical care nursing, neonatal care nursing, and rehabilitative nursing. Hospital will continue to be the principal employers of registered nurses in the foreseeable future.

PUBLIC HEALTH NURSING OR COMMUNITY HEALTH NURSING Public health nursing is also called community health nursing. The National Health Program of the Philippines gives as much emphasis on the promotion of health and prevention of diseases rather than care of the sick. It needs a deeper involvement and close cooperation with all members of the health team such as physicians, nurses,

epidemiologists, dentists, sanitary inspector, sanitary engineers, nutritionist, health educators, social workers, the community, and the barangay leaders. Effective coordination can be best achieved if all members have an understanding of, and respect for, each others function.

Advantage of Public Health Nursing 1. The focus of nursing care is only on family and community health rather than on an individual basis. Here, the nurse will be able to see the total picture of family and community health. 2. It gives the nurse a better perspective of the health conditions of the community and health programs conceived and implemented by the government, and to appreciate the nurses role in national building. 3. It maximizes efforts to improvise where there are no sufficient facilities, supplies, and equipment. 4. It enables the nurse to utilize various community resources and maximize coordination with other members of the health team. 5. Focus of care is more on educational and preventive aspects. Thus, nurses have the privilege of contributing to the program for healthy citizenry especially among the rural poor. 6. Individuals, families and communities are motivated to assume responsibility for their own health care.

Disadvantages of Public Health Nursing 1. Cases found in public health nursing are limited mostly to chronic and/ or communicable diseases. 2. There are more hazards in public health than in hospital nursing, such as exposure to elements (inclement weather, heat of sun, rain), dog or snake bites, accidents, etc.

3. There are no fixed hours of work. The nurse may be called upon any time of the day or night. 4. Some claim that public health nursing is not as exciting or as glamorous as hospital work. 5. Facilities for care of the sick are limited so that practice or skills may also be limited. 6. The public health nurse may not be immediately aware of changes or trends in fields of medicine or nursing. 7. Public health nursing is not a place for introverts. A nurse has to be outgoing to meet people. 8. There is no immediate supervisor to consult in case of emergency.

With the implementation of Primary Health Care, public health nurses are kept upto- date through various continuing education programs conducted by the Department of Health and Regional Health Offices. The entry salary of a community health nurse is the same as that of a Senior or Head Nurse in government hospital.

NURSES IN IN-SERVICE UDUCATION PROGRAMS In-service education programs have been in existence for many years both in hospitals and public health agencies. Many tertiary hospitals and public health agencies have nursing staff in charge of staff development training and research.

Nurses in this field need: 1. Skills in nursing practice, therefore they must have experience of at least two years in basic nursing practice; 2. Understanding of skills in teaching. Supervision, and consultation; 3. Understanding of the relationship of these person to these process of administration and research;

4. Understanding of the broad problems and desirable practices in patient-care planning; 5. Understanding od and skills in the use of problem solving approach to resolve every day problems in the practice of nursing and in-service of the areas of concern; 6. Understanding of the role and functions of the revising personnel in this area of in-service education; 7. Understanding of self and others involved in in-service education within the various agencies in nursing; and 8. Ability to plan and implement programs for different kinds of nursing personnel.

Nursing coordinators for Staff Development need to have at least four years of clinical practice and research and a Masters Degree in Nursing. Nurse Instructors for inservice training programs need at least two years of experience in clinical practice and research and a masters Degree in Nursing preferably with a clinical specialization. With the advent of Quality Assurance Programs in health services, nurses may also be employed as Quality Assurance Coordinators in agencies where this program is required. Nurses in this field need experience in clinical nursing and research too.

PRIVATE DUTY NURSING Nurses in private practice are expected to be expert clinicians as well as expert generalist in nursing. They use the title Private Duty nurse, Private Nurse Practitioner, Special Duty Nurse or Private Duty Nurse Specialist.

Definition of Private Duty Practitioner A private duty nurse is a registered nurse who undertakes to give comprehensive nursing care to a client on a one-to-one ratio. She/he is an independent contractor. The patient may be provided care in the hospital or in the home.

Private duty nurse practitioners are grouped into two categories. 1. General Private Duty Nurse. The general private duty nurse has a capabilities for providing basic nursing care to any type of patient, among which are: a. Assessment of the physical conditions and interpretation of the significance of his/her finding as basis for planning the nursing care; b. Identification of emotional and social factors and relating these to signs and symptoms observed; c. Application of scientific principles in the performance of nursing techniques; d. Working with patients family so that they gain understanding of his/her illness and cooperate towards promoting early recovery of the patient; e. Utilization of the laboratory and diagnostic test in promoting progress of care and enhancing his/her own usefulness as a health teacher and counselor; f. Knowledge and recognition of pharmacology effects of drugs and medications, their implications of nursing actions as needed; and g. Interpretation of doctors orders concerning medicines and treatments and communicating the same effectively to the patient and carrying them out promptly and accurately with understanding of cause and effect. 2. Private Duty Nurse Specialist. In addition to the foregoing abilities expected of the general nurse practitioner and as a result of his/her specialized preparation, a private duty nurse specialist also demonstrates the following competencies: a. Skills in handling, operating, and monitoring other complicated devices; b. Skills interpreting data gathered from ECG, EEG, laboratory diagnostic results and vital signs; c. Skills in observing signs and symptoms and their favorable or untoward significance in the progress of patient care; and d. Promptness adeptness in instituting appropriate nursing measures.

Qualifications of a Private Nurse Practitioner

A private nurse practitioner must: 1) Be a registered nurse in the Philippines; 2) Have the following documents for the current year: a. Professional Tax Receipt (PTR) b. Professional Regulation Commission Card (PRC), and c. Residence Certificate 3) Have at least two (2) years of bedside nursing experience as a professional nurse in general hospital immediately prior to application; 4) Be acceptable to the Director of Nursing Service as suitable for orientation to do private duty nursing; 5) Be a full time private duty nurse; 6) Preferably have undergone a Critical Care Nursing Course; and 7) Be a certified I.V Nurse Therapist by the ANSAP (association of nursing science administrator in the Philippines)

Requirements A private nurse practitioner is required 1) To undergo orientation in the hospital as conducted by the Nursing Service Office; 2) To have the complete paraphernalia, e.g., blood pressure apparatus, pen light, bandage scissors, red and blue or black pen, and clip board; 3) To wear full white nurses uniform (cap, stoking, closed white shoes, I.D, pin). Uniform blazers may be used if required by the hospital; 4) To have a medical certificate from a certified medical center or laboratory with chest-x-ray result, CBC, urine and stool examination; 5) To give two (2) character references; 6) To acquired, for succeeding years, certificate of three (3) seminars or continuing education programs attended; and

7) To show certification as an I.V. Therapist by the ANSAP. The private duty nurse is expected to follow the rule and regulations of the hospital regarding nursing procedures, use and procurement of equipment and supplies, system of medications, charting, diets, precaution techniques and others. As in other fields of nursing, he/she is expected to adhere to the code of ethics and practice. General Guidelines 1) Although a private duty nurse is considered an independent contractor, she/he is directly under the supervision of the nursing service in the hospital, or of the Head Nurse in the unit. She/he is expected to make a comprehensive verbal report to the chief nurse or supervisor when they visit the patient and submit a written report to the head nurse at the close of the shift. 2) The private duty nurse is responsible for the nursing care of the patient. 3) The private duty nurse shall endeavor to give complete nursing care before going off-duty. 4) While the private duty nurse on house case is directly responsible to the attending physician of the patient, a regular monthly service audit shall be given to the Director of Nursing Services who referred her/him for employment.

Policies and guidelines for nurses accompanying patients out of the country 1) Passport and other travel papers. The patient or his/her representative pays for all expenses for fees and processing of visa and travel papers. a. Passport, paid round trip ticket, and other papers should be in the possession of the private duty nurse of all times. b. A travel and accidental insurance in the amount of P50, 000.00 shall be provided for the private duty nurse and paid for by the patient or his representative effective 72 hours before departure

and throughout the period of stay abroad while in the employment of the patient. c. The corresponding amount of salary computed at eight (8) hours multiplied by two (2) shifts and the number of days the patient plans to be out of the country should be left in the Philippines for ready withdrawal by the private duty nurses authorized representative on designated dates per agreement of parties concerned. d. A daily travel allowance in additional to the private duty nurses regular salary while out of the country is negotiable with the employer. e. The female private duty nurse who is caring for a male patient must be provided a separate room for rest periods. f. All hotel, lodging and food expenses while out of town or out of the country shall be paid for by the employer. 2) The private duty nurse is required to: a. Leave with the Private Duty Nurses Association in the Philippines her/his possible address of destination and tentative duration of duty. b. Report present to the nearest nursing organization in the area; and c. Report to the Philippine Nurses Association his/her arrival in the country. Advantage of Private Duty Practice Private duty practice gives the following advantages: a. The chance to see life as it really is, to study human nature and to know at close range interesting people of different nationalities, culture, religion. And status; b. The opportunity to make real friends through close association with the patient and his family; c. The chance to travel and see the world;

d. The ability to own time, adjust work and private life satisfactorily, and direct offduty time into enjoyable leisure; e. The chance to keep abreast with new knowledge and procedures which provide an exciting, stimulating experience, with infinite variety of problems to solve and personal satisfaction to be gleaned; and f. The challenge of giving his/her best in providing care and having the satisfaction of seeing its result. Disadvantages of Private Duty Practice a. Some private duty nurses create in situation in which the patient is become totally dependent on them. b. Many private duty nurses are graduated so long ago and have not upgraded their knowledge and skills. c. There are not enough nurses for evening and night shifts, for holidays, weekends, and vacation periods. d. Being a lone practitioner minimized opportunity for developing good relationship with other hospital personnel. e. Some private duty nurses resent supervision by hospital staff. f. Little assistance is given by the Head Nurse when the patient is critically ill and the private duty nurse needs helps in giving treatment or in changing the position of the patient. The private duty nurse sometimes goes without meals because the Head nurse does not arrange for relief when the patient cannot be left alone. g. Private duty nurses have a little or no participation in professional activities, if they ever do; they do so on their own time and expense. h. Nurses who are very experience and well qualified receive the same fees as the new graduates. i. Private duty nurses face problems in private practice being independent contractors and there is greater needs for liability insurance. j. There is no retirement, insurance and Medicare benefits unless the private duty nurse provides these for himself or herself.

The private duty nurses association of the Philippines defined the categories of the private nursing practitioners in 1975. In February 1976. It submitted to the Philippines Nurse Association the proposal to revise the rate from a twelve hours basis. Standards rates for Private Duty Nursing was approved by the Board of Directors, Philippines Nurses Association in February 1976. The rates to be changed for private duty are determined by the Private Duty Nurse Association of the Philippines, anyone interested may verify from the Philippines Nurses Association Headquarters or at the Nursing Service Office of Lourdes Hospital in Mandaluyong City.

OCCUPATIONAL HEALTH NURSING OR INDUSTRIAL NURSING Occupational Health Nursing was once called industrial nursing. In 1958, industrial nurses in the United States is elected to call themselves occupational health nurses to reflect the broader and changing scope of practice within the specialty. Most of these nurses have experienced working in hospitals, in public health or some other branch of the profession. Few nurses go into occupational health nursing. This is because occupational health nurses often work alone, and most therefore possess maturity, experience, and wise judgment. Occupational nursing is the specialty practice that provides and deliver health care services to workers. The practice focuses on promotion, protection, and supervision of workers health within the context of a safe and healthy work environment. Occupational health nursing is autonomous and occupational health nurses make independent nursing judgments in providing health services. Since occupational health nurses work alone in situations where they may have to give immediate care to patients with serious injuries, they need to be fully informed about their legal responsibilities. The first consideration is the patients welfare. They must make use of whatever first aid and nursing measures they judge necessary, bearing in mind their professional limitations. Emergency or more extreme measures may be used

during life-and-death situations. Their actions will be judged against the yardsticks of reasonable, prudent nursing practice. As in other fields of nursing, a Bachelors Degree in Nursing is required of occupational health nurses. This field of nursing requires special skills. A good preparation is a year or more in emergency nursing such as actual nursing experience under the direction of a skillful nurse in this field. Helpful skills include ability to take and read ECGs, eye screening, audiometer testing, laboratory tests, and X-ray. In addition, industrial nurses must know company policies on personnel, insurance benefits, sick leave, pay rates, health programs, medical maters and records. Since industrial nurses may have only part time or on-call medical direction, they may find themselves custodians employees health records, counselors and advisers of the workers, interpreters of company policies, health and safety teachers as well as first aiders to the injured. Most occupational nurses have to bargain individually for their salaries. Only few employers hire enough nurses to make up a bargaining unit. This has hurt salaries in industrial nursing to an extent and pay is probably less than in hospital work. But there are compensations. Often, the industrial nurses works only during day hours. They are off duty on weekends most of the time. Exception to these are nurses in large plants which may require overtime work. These are usually seniority wage increases, pensions and insurances. Fortunately beginners in this fields have a wide variety of help available. Valuable literature may be obtained from many sources. They may also seek support from fellow practitioners through the Occupational Health Nurses Association of the Philippines.

NURSING EDUCATION Carrier opportunities in nursing education are better today than ever before. There is a chronic teacher shortage in all nursing education programs. Nurses who likes to

consider teaching as their field of expertise will have to consider the following qualifications (appendix K.) Qualifications of the Faculty A member of the faculty in a college of nursing teaching professional courses must: a. Be a registered nurses in the Philippines; b. Have at least one (1) year of clinical practice in a field of specialization; c. Be a member of good standing in the accredited professional organization of nurses; and d. Be a holder of a masters degree in nursing, education, or other allied medical and health sciences conferred by a college or university duly recognized by the government of the Republic of the Philippines.

The practice of some school to hire as faculty members those under board nurses or those without any experience contributes to the poor quality of nursing students who later will become incompetent nurses themselves. This practice also subjects said nurses and their employers to legal problems that may arise later. Personal qualities and special abilities of faculty members include: a. Capability to promote interest in the subject they teach; stimulate the mind of the students. Arouse enthusiasm, quicken imagination, and awaken ambition; b. Competence in the particular field they teach; c. Resourcefulness with infinite patience, understanding, confidence and perseverance. They must be able to inspire students to develop their fullest potential; and d. Expertise in providing nursing care in the chosen fields aside from the qualities of good role models. The career ladder in nursing education starts with a Clinical Instructors position up to the Dean of a college of Nursing.

A dean in a college of nursing should possess a Masters Degree in Nursing and must have at least five (5) years of experience in teaching and supervision as per R.A. 9173. Those teaching at the graduate Programs for Nurses must possess post- Masters Degree or a Doctoral Degree in Nursing. Generally, salaries of those in the field of nursing education are higher than those working in the hospitals. These vary according to the teachers experience, their fields of specialization and their educational attainments. Nursing education is an interesting, important, and challenging field and the opportunities for well- prepared nursing educators are numerous.

MILITARY NURSING The Nurse Corps When the famed Tandang Sora led the nursing of the sick and wounded Katipunan revolutionaries in 1980. Military nursing in the Philippine may be said to have begun. However, the Nurse Corps we know today dates back more precisely about three decades ago, shortly before the outbreak of World War II. Commonwealth Act No. 1, commonly known as the National Defense Act, clearly for the establishment of a medical service in the army of the Philippines. However, the component corps were not specified. On September 5, 1938, the National Defense Act was amended by Commonwealth Act. No. 385 whereby the different corps of the medical service were explicitly spelled out, with the Nurse Corps being one of them. This is the date celebrated by the Nurse Corps as its foundation day. In spite of the legal basis for its existence, the Nurse Corps was not organized until about mid-1940, when President Manuel L. Quezon issued Executive Order No. 2167, dated April 25, 1940. This provided for the rules of the organization of the Philippine Army Nurse Corps Reserve intended to be mobilized in the event the Philippines would be involved in the impending war in the Far East. In accordance with this new legislation, nurses begun to be commissioned early as July1940. At about this

time in the U.S Army, the Army nurses were given only relative marks as officers. Perhaps this was the reason why those who were first commissioned under the Nurse Corps were only given relative ranks as second and third lieutenant depending on their age, education, and experience. To emphasize the female composition of the Corps, them the Nurse Corps as provided for in C.A. 385, was changed to the Female Nurse Corps pursuant to commonwealth Act No. 569, dated June 7, 1940. By the end of 1941, there were about 200 nurse commission into the Nurse Corps. For some unknown reasons, the legal basis of the Nurse Corps existence under the Philippine government became Executive Order No. 267, the provision of which was very far from the benefits given by the USAFFE. To prevent retrogression in the status of the military nurses, they began the long and tedious fight because the military authorities were not very sympathetic with the plight of the military nurses. With the aid of the Philippines Nurses Association, the military nurses were able to lobby at the congress for the passage of a bill that would re-designate the female nurses as a component of Medical Service. As Nurse Corps, the members would be guaranteed the same rights and privileges as those granted the other members the military. This resulted in the approval of Republic Act No. 203 on May12, 1948 by Pres. Elpidio Quirino, placing the Nurse Corps in proper perspective among the other military organizations. R.A. 479 of June 10,1950 amended R.A. 203, and gave credit to the service of the military nurses during war. It also provided basis for determining the grade and rank, seniority, and retirement of NC officers. In August 1952, the title Army Nurse Corps, Medical Service, was change to Nurse Corps, AFP, Regular officers were integrated in 1953. Prior to 1973 the Chief Nurse was merely a staff of the office of the Surgeon General and had to direct management and administrative functions in the AFP Nursing Service. With the activation of the office of the Chief Nurse in the Armed Forces of the Philippines and the designation of the Chief Nurse as Technical Staff of General Headquarters on June 21,1973, the Chief Nurse has been afforded the prerogative to decide on matters purely affecting the Nurse Corps and the nursing personnel in the

Armed Forces of the Philippines. This position now holds the rank of a Brigadier General. The first military nurse to hold this rank was Brig. Gen. Elvegia R. Mendoza. Function of the Nurse Corps, AFP The AFP Nurse Corps provides comprehensive and quality nursing care to military personnel, their dependents and authorized relatives. The function of the AFP Nurse Corps may be grouped into three (3) broad areas: a. To meet the nursing needs of todays patients in AFP medical facilities; b. To prepare each Nurse Corps officer (regular and reserve) for future assignments at a higher level of responsibility in the different station and general hospital in times of peace and war; and c. To teach and train enlisted personnel who perform nursing functions under supervision. Special emphasis is on enlisted members who function in settings where there are no nurses. Qualification of the Military Nurse Principle. The nurse consciously and scientifically intervenes in the health and illness environment for the purpose of ensuring that the soldier, his family and other significant groups will have adequate personal care, maintenance, safety, and comfort. Rationale. The military nurse works at different health settings with various levels of responsibilities. As such, he/she must have the professional, personal and other qualifications commensurate with job responsibilities. Criterion I- Qualification for Commission in the Reserve Force Nurse Corps Anyone who wants to be commissioned in the Reserve Force Nurse Corps must a. Have a Bachelor Science in Nursing from a duly recognized university/college; b. Be licensed to practice nursing; c. Be a natural born- Filipino citizen;

d. Be single or has never been married for both male and female candidates. Female applicants must not positively be found to have given birth to a living or still born child; e. Be mentally and physically fit for military services and cleared by appropriate security agencies; f. Have pleasing personality and a good moral character; g. Be skillful in i. Applying the nursing process in meeting health/nursing needs of individuals/families/groups/communities; ii. iii. Communicating and relating with others Making sounds/ rational judgment in a given situation;

h. Be interested and willing to work in both peaceful and wartime conditions; i. Not be more than thirty two (32) years of age at time of commission; and j. Satisfy the following requirements i. ii. Minimum of sixty two (62) inches foe male, and a Minimum of sixty (60) inches for female.

Qualifications for Commission in the Regular Force, Nurse Corps In addition to the requirements for commission in the Reserve Force, anyone who wants to be commission in the Regular Force, Nurse Corps must a. Successfully pass the rigid screening and battery test for the purpose; b. Satisfy the height requirements of i. ii. Minimum od 64 inches for males; and a Minimum of 62 inches for a females; and

c. Not be more than 26 years of age at the time of regular commission.

Qualifications for Call to Active Duty (CAD)

Anyone who seeks to be qualified for CAD a) Must be commissioned;

b) Must have at least one year nursing experience in a reputable health agency; c) Must have been cleared by appropriate security agency; and d) Must have passed the physical and mental examinations conducted by the appropriate authorities. Qualification for General Duty Nurse Anyone who desired to be qualified as General Duty Nurse a) Must have the rank of Second Lieutenant; b) Must adequate knowledge of a general nursing theory and practice, including basic knowledge about biological, social, and medical sciences and their application; c) Must have knowledge of new development in the nursing field; and d) Must demonstrate ability to perform comprehensive nursing care. Characteristics of the Work As in the other civilian hospitals, nursing service in military seeks to provide the highest quality of nursing care to patient: in-patient in the hospital and out-patient in the dispensaries, like in other hospitals, they also maintain different section like the surgical intensive care unit, the Operating Room and Anesthesia Sections, The recovery Ward, OB-Gyne, Pediatric, Neuropsychiatry, Nuclear Medicine Sections and the Family Planning Section manned by nurse specialists who have been trained locally and abroad. The medical corpsmen are highly trained enlisted personnel who help in the care of patients, especially the males. Nursing attendants are unskilled non-professionals, who assist nurses and doctors in the wards. In times of emergency and as the exigency of the services to requires, the corpsmen and attendants are authorize to do other medicosurgical procedures like injection, giving medications, catheterizations, castings, intravenous infusions, circumcisions, suturing of wounds, and other duties as may be required of them. Privileges and Benefits of a Military Nurse

Enumerated below ate he benefits and privileges which military nurses are entitled to received. 1. High salary rate allowance according to rank: a. As second lieutenant, they will initially receive the same base pay as officers of equivalent rank, incentive pay, subsistence allowance, quarters allowance, clothing allowance, and others when applicable; b. Flight pay for flight nurses which is 50% of base pay; c. Hazard pay (radiation hazard pay) which is 20% of base pay; d. Cold weather clothing allowance for those assigned in cold regions like PMA I Baguio, or areas abroad; and e. Overseas pay when detailed to foreign countries on schooling, or on missions; 2. Glamour and prestige of the uniform rank and position. All junior officers and enlisted personnel will salute and accord them due military courtesy; 3. Hospitalization and free medication benefits for parents, dependents, authorized relatives with specialist care; 4. Military schooling and basic training at the Armed Forces Medical Services School ay the V. Luna Medical Center (VLMC); 5. Opportunity to meet people who hold key positions in the AFP and in the government; 6. Opportunity to attend gala, social functions and parade; and 7. Opportunity to travel abroad.

Flight Nursing in the Philippines One field of nursing that is considered peculiar only to the military and to the Air Force is flight nursing or aero-space nursing. A flight nurse is responsible for patients, military or otherwise, who have been evaluated from battle areas to the nearest installation for treatment. Air evacuation relieves congested areas, giving way to forward moving vehicles and troops. It also reduces medical personnel and supply requirement of military

operations. Furthermore, it prevents the possible loss of life due to shock or injuries and cuts down permanent disability to the minimum. Early hospitalization and faster relief pain bolster the morale of both patients and effective troops left in the battle areas and places of assignment. The aero-medical section of the different air base of the Philippines Air Force is tasked with carrying out this mission in line with the overall objectives of the AFP Medical Service, which is to conserve the fighting strength of the troops. A flight nurse is a commissioned officer of the Nurse Corps in the active service, usually assigned in the Philippines Air Force (PAF), and who as undergone special training and instruction about flight nursing in the Philippines or abroad. A great percentage of flight mission include evacuation of civilians, mostly indigents, who come from areas not usually reached by commercial airlines. On such mission, the flight is the most important member of the aeromedical team. More often than not, medical missions are performed without a flight surgeon.

SCHOOL HEATH NURSING School health nursing is very different from hospital nursing. School health nurse must like children a lot. They often work alone, out of touch with other nurses, the hospital and all professional supports they have known. They are responsible for the schools activities in the areas of health service, health education and environmental health and safety. The primary function of the school in education. The health program of each school is geared toward making the students and faculty understand those programs which emphasize health promotion, prevention of disease, and follow-through of any findings that may indicate a need for medical care and treatment. They perform a wide variety of services including basis screening for vision, hearing, and risk factors that would interfere with the development of a healthy lifestyle.

For a school nurse, team relationship with other members of the school staff and participation in their activities will depend on the size of the school, the community, the health needs of the pupils, and availability of other personnel such as social worker or guidance counselors. Some responsibilities of the school nurse are: 1. Organizing and implementing the school health program; 2. Coordinating school health program 3. Undertaking functions directly related to pupils health; 4. Evaluating school health programs; and 5. Carrying out function related to the health of school personnel. Advantages of School Nursing School nursing affords one the opportunity to watch children advance from grade in school health. Hours are usually good and there is no shift duty. Disadvantages Many school nurses di not update themselves on the current issues in nursing making them unaware of changes in the nursing practice. School nurses should enjoy working with children and should be able to work trough, and with others to achieve their objectives. They should accept the educational functions of the school and be committed to the promotion of health through education.

CLINIC NURSING Clinic nursing requires that a nurse possess general skills. Usually a doctor has been in general practice for a number of years. It his with him that the nurse acts as a receptionist, answers phone, does the billing, take x-ray and ECGs, changes dressings, gives injections (such as BCG, DPT. Or measles vaccine), and assist in physical examinations. The nurse may even do autoclaving of instruments, keep records, order and store supplies, make follow up calls and referrals for patients. Teaching patient and their families has become a important function of the clinic nurse. nurses in the field must have

excellent teaching and communication skills, exhibits organizational and leadership ability, possess good assessment skills, and good insight in order to anticipate and interpret the needs of their patients. The advantages of clinic nursing are affordable working hours, the satisfaction of working with people they know and like and who know and like them in return. Efficient clinic nurse are trusted in their judgment and share in planning the care of the patient. Generally, and on the average, clinic nurses receive a slightly lower salary than hospital nurses. A written contract setting forth the professional and personal arrangements between the nurse and the employer can be mutually beneficial.

ADVANCE PRACTICE NURSING This field of nursing is synonymous with specialization. Even specialization is a hallmark of a mature discipline. The advance practice nurse is an umbrella terms for nurses who have specialized education and experience beyond the basic nursing program. This advance practice required the knowledge and skills and supervised skills obtained through graduate study in nursing (either masters or doctoral degree). This field covers the role of the clinical nurse specialist. The clinical nurse specialist is also known as a nurse specialist, nurse clinician or clinical specialist. The clinical specialist is an expert practitioner within the specialized field of nursing some may concentrate on cancer, rehabilitation, care of patients with ostomies, neurological conditions, psychiatry, and many other subspecialists. These nurses participate in a range of sub roles including. direct patient care, research , teaching, consultation, and management.

INDEPENDENT NURSING PRACTICE How would you like to hang at your gate or window a sign bearing your name and the words Independent Nurse Practitioner? Here in the Philippines, there are already

few nursing clinics, a group of nursing specialists, and a project subsidized by the Philippines Nurses Association, where in nurses do independent nurse practice. As the term implies, independent means the nurse is self-employed and provides professional nursing services to the client/patients and their families. While some independent nursing practitioners set up their clinics near the hospital, most of them are community-based. These nurses reach out and offer their services rather than expect client to seek their help. They perform both independent and collaborative roles. Health care assessment, formulating plants for health maintenance, prevention strategies of supportive activities in critical and complex health problems are all within the scope of nursing practice. They make referrals and collaborate with physicians and the other disciplines as needed by the client or family. Independent nurse practitioners are accountable for their decisions. Whether their role is independent or collaborative, it is based in the fact that each health care discipline offers an area of knowledge and expertise. Collaborative work is needed for effective, efficient, an economical care. It is essential therefore that independent nurse practitioners acquire working knowledge of the skills and expertise of other health workers. Predicted Outcome of the New Role of Nurses as Independent Nurse Practitioners The growing interest in independent nursing practice is expected to contribute much to the improvement of health care in the country. 1. It will encourage professional nurses to extend their capabilities and assume greater responsibilities for designated areas in generalized nursing practice. 2. The amount of health care will more increased and accessible to people. 3. The nurses involvement in the clients family or community will increase the nurses sensitivity and response to their clients needed. 4. Improvement of health services will help prevent serious illnesses and maintain positive community health programs. 5. It will provide data for nursing education, to validate and legitimize extended role practices for nurses.